伴有肉芽肿反应的生殖细胞瘤。鉴别诊断问题。

Germinoma with a granulomatous reaction. Problems of differential diagnosis.

作者信息

Konno S, Oka H, Utsuki S, Kondou K, Tanaka S, Fujii K, Yagishita S

机构信息

Department of Neurosurgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan.

出版信息

Clin Neuropathol. 2002 Nov-Dec;21(6):248-51.

PMID:12489672

Abstract

The patient was a 6 year-old girl with a progressive loss of visual acuity. Magnetic resonance imaging showed a suprasellar mass lesion with enhanced gadolinium which was resected. Histopathological study showed a remarkable granulomatous reaction, but a diagnosis was difficult. However, immunohistochemical study showed a few cells that were positive for placental alkaline phosphatase and it was diagnosed as germinoma. Intracranial germinoma with a remarkable granulomatous reaction is rare. However, when germinoma is suspected clinically, an immunohistochemical study is able to identify germinoma even if granulomatous disease is diagnosed histopathologically.

摘要

该患者是一名6岁女童，视力逐渐下降。磁共振成像显示鞍上有一肿块病变，钆增强后进行了切除。组织病理学研究显示有明显的肉芽肿反应，但诊断困难。然而，免疫组织化学研究显示少数细胞胎盘碱性磷酸酶呈阳性，诊断为生殖细胞瘤。颅内生殖细胞瘤伴有明显肉芽肿反应较为罕见。然而，临床上怀疑生殖细胞瘤时，即使组织病理学诊断为肉芽肿性疾病，免疫组织化学研究也能够识别出生殖细胞瘤。